Individual provider Active NPI

Kim B. Knox, NP

  • Nurse Practitioner
  • Edmond, OK
National Provider Identifier
1871554808
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R0047398 Issued in OK
Practice address
3801 NW 166TH St Ste 4
Edmond, OK 73012-9279
Phone
(405) 359-1122
Fax
(405) 359-1100
NPI assigned
Mar 29, 2006
Last updated
Dec 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R0047398 OK Primary

Addresses

Primary practice location

3801 NW 166TH St Ste 4
Edmond, OK 73012-9279

Mailing address

3801 NW 166TH St Ste 4
Edmond, OK 73012-9279
Phone (405) 359-1122

Other identifiers 2

IdentifierTypeStateIssuer
100136730AMedicaidOK
100136730BMedicaidOK

Other names 1

  • Kim Binkley Dever Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041004000142 OK Practitioner - Nurse Practitioner 8921077215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deer Creek Family Healthcare and Wellness Clinic LLCGroup PAC ID 6709007099, 4 clinicians

Practice addresses (Care Compare)

3801 NW 166TH St
Suite 4
Edmond, OK 73012-9279
Phone (405) 359-1122

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0047398OKMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Creek Family Healthcare and Wellness Clinic LLC CurrentSince Sep 1, 2014 Accepting new patients
Mercy Health Services Inc. Past Accepting new patients
Summit Medical Center Past Accepting new patients
Neighborhood Family Clinic and Minor Emergency Services Past Accepting new patients
Neighborhood Family Clinic & Minor Past Accepting new patients

Locations

19409 N Portland Ave
Edmond, OK 73012
Phone (405) 359-1122

3801 NW 166th St
Ste 4
Edmond, OK 73012
Phone (405) 359-1122

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1871554808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 NW 166TH ST STE 4",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129279",
            "telephone_number": "405-359-1122",
            "fax_number": "405-359-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 NW 166TH ST STE 4",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730129279",
            "telephone_number": "405-359-1122",
            "fax_number": "405-359-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOX",
        "first_name": "KIM",
        "middle_name": "B.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0047398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100136730A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100136730B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "DEVER",
            "middle_name": "BINKLEY",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.